Respiratory Syncytial Virus (RSV)

Wednesday, September 20th, 2017

The respiratory syncytial virus (RSV) is a major cause of infections of the breathing passages and lungs in infants and young children., It is one of many viruses that can
cause bronchiolitis (an infection of the bronchioles, the small
breathing tubes of the lungs). Other causes of bronchiolitis,
are influenza,
parainfluenza virus, or adenovirus.

Respiratory virus is
transmitted from an infected child by secretions from the nose or mouth of an
infected person, by direct contact, or airborne droplets. The period of
greatest contagiousness is in the first few days of the infection. The
incubation period of RSV ranges from 2 to 8 days, commonly 4 to 6 days. Annual
epidemics take place during the winter and early spring.

Signs
and Symptoms

Most children with respiratory
infections have only mild symptoms, typically similar to the symptoms of a
common cold.
In children younger than 2 years, the infection may progress to symptoms more
commonly found in bronchiolitis.

Initially, the child will have a runny nose, mild
cough, and in some cases, a fever.
Within 1 to 2 days, the cough will get worse.
At the same time, the youngster's breathing will become
more rapid and difficult. He may wheeze each time he breathes out.
Your child will have a hard time drinking because he is
using so much energy breathing. Even swallowing becomes very difficult for
these infants.
His fingertips and the area around his lips may turn a
bluish color, a sign that his strained breathing is not delivering enough
oxygen to his bloodstream.

What
You Can Do

In the early stages of a respiratory
infection, help ease your child's cold-like symptoms. Gentle suctioning of the
nose may be useful to clear the nostrils. You should not use medications as
they may cause side effects and are not effective in the young child.

Mist has not been shown to be
useful. Hot-air vaporizers should be avoided because of the risk for scald
burns, and cool-mist vaporizers are often contaminated with molds. Make sure
your child drinks enough liquid to prevent dehydration.

When
to Call Your Pediatrician

Contact your pediatrician
immediately if your baby or child:

Has breathing difficulties
Is younger than 2 or 3 months and has a fever
Shows signs of dehydration, such as a dry mouth, crying
without tears, and urinating less often

How
Is the Diagnosis Made?

Your pediatrician may order
laboratory tests of specimens taken from your child's nose and throat to see if
RSV or another virus is present. The virus can be grown in special cultures, or
parts of the virus can be identified by rapid tests.

Treatment

There is no effective treatment for
RSV or other viruses (other than influenza). Observation for worsening
is necessary. If worsening occurs, you should call your doctor. Some youngsters
with bronchiolitis may have to be hospitalized for treatment with oxygen. If
your child is unable to drink because of rapid breathing, he may need to
receive intravenous fluids. On rare occasions, infected babies will need a
respirator to help them breathe.

Antibacterials are not used for
treating viral infections.

What
Is the Prognosis?

Most children with viral infections
are well on their way to recovery in about a week, and almost all fully
recover. Nearly all children are infected with RSV at least once by 2 years of
age, and a mild recurrence of the infection throughout life is common. As the
child grows, viral infections become less serious than when they were infants
and are usually hard to distinguish from a cold.

These infections can make chronic
breathing conditions worse. Infants with congenital heart disease may have a more severe case of RSV. Some children will
require hospitalization, and a few will need intensive care.

Prevention

Your child should avoid close
contact with other children and adults who are infected with viruses. In child care centers, good hygiene practices should be used by the staff and the
children, including frequent and thorough hand washing.

Palivizumab is an antibody that may
reduce the risk of RSV infection. It is given as an intramuscular shot once a
month to children who are at increased risk for serious illness caused by RSV.
These include very premature babies and some babies with chronic lung disease.